Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial
BackgroundHypoglycemia is a frequent and acute complication in type 1 diabetes mellitus (T1DM) and is associated with a higher risk of car mishaps. Currently, hypoglycemia can be detected and signaled through flash glucose monitoring or continuous glucose monitoring devices,...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2024-01-01
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| Series: | JMIR Human Factors |
| Online Access: | https://humanfactors.jmir.org/2024/1/e42823 |
| _version_ | 1827386186912497664 |
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| author | Caterina Bérubé Vera Franziska Lehmann Martin Maritsch Mathias Kraus Stefan Feuerriegel Felix Wortmann Thomas Züger Christoph Stettler Elgar Fleisch A Baki Kocaballi Tobias Kowatsch |
| author_facet | Caterina Bérubé Vera Franziska Lehmann Martin Maritsch Mathias Kraus Stefan Feuerriegel Felix Wortmann Thomas Züger Christoph Stettler Elgar Fleisch A Baki Kocaballi Tobias Kowatsch |
| author_sort | Caterina Bérubé |
| collection | DOAJ |
| description |
BackgroundHypoglycemia is a frequent and acute complication in type 1 diabetes mellitus (T1DM) and is associated with a higher risk of car mishaps. Currently, hypoglycemia can be detected and signaled through flash glucose monitoring or continuous glucose monitoring devices, which require manual and visual interaction, thereby removing the focus of attention from the driving task. Hypoglycemia causes a decrease in attention, thereby challenging the safety of using such devices behind the wheel. Here, we present an investigation of a hands-free technology—a voice warning that can potentially be delivered via an in-vehicle voice assistant.
ObjectiveThis study aims to investigate the feasibility of an in-vehicle voice warning for hypoglycemia, evaluating both its effectiveness and user perception.
MethodsWe designed a voice warning and evaluated it in 3 studies. In all studies, participants received a voice warning while driving. Study 0 (n=10) assessed the feasibility of using a voice warning with healthy participants driving in a simulator. Study 1 (n=18) assessed the voice warning in participants with T1DM. Study 2 (n=20) assessed the voice warning in participants with T1DM undergoing hypoglycemia while driving in a real car. We measured participants’ self-reported perception of the voice warning (with a user experience scale in study 0 and with acceptance, alliance, and trust scales in studies 1 and 2) and compliance behavior (whether they stopped the car and reaction time). In addition, we assessed technology affinity and collected the participants’ verbal feedback.
ResultsTechnology affinity was similar across studies and approximately 70% of the maximal value. Perception measure of the voice warning was approximately 62% to 78% in the simulated driving and 34% to 56% in real-world driving. Perception correlated with technology affinity on specific constructs (eg, Affinity for Technology Interaction score and intention to use, optimism and performance expectancy, behavioral intention, Session Alliance Inventory score, innovativeness and hedonic motivation, and negative correlations between discomfort and behavioral intention and discomfort and competence trust; all P<.05). Compliance was 100% in all studies, whereas reaction time was higher in study 1 (mean 23, SD 5.2 seconds) than in study 0 (mean 12.6, SD 5.7 seconds) and study 2 (mean 14.6, SD 4.3 seconds). Finally, verbal feedback showed that the participants preferred the voice warning to be less verbose and interactive.
ConclusionsThis is the first study to investigate the feasibility of an in-vehicle voice warning for hypoglycemia. Drivers find such an implementation useful and effective in a simulated environment, but improvements are needed in the real-world driving context. This study is a kickoff for the use of in-vehicle voice assistants for digital health interventions. |
| first_indexed | 2024-03-08T15:42:30Z |
| format | Article |
| id | doaj.art-1e4b350e113548a68878864120251206 |
| institution | Directory Open Access Journal |
| issn | 2292-9495 |
| language | English |
| last_indexed | 2024-03-08T15:42:30Z |
| publishDate | 2024-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Human Factors |
| spelling | doaj.art-1e4b350e113548a688788641202512062024-01-09T14:30:34ZengJMIR PublicationsJMIR Human Factors2292-94952024-01-0111e4282310.2196/42823Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility TrialCaterina Bérubéhttps://orcid.org/0000-0001-5247-8485Vera Franziska Lehmannhttps://orcid.org/0000-0002-6038-809XMartin Maritschhttps://orcid.org/0000-0001-9920-0587Mathias Kraushttps://orcid.org/0000-0002-2021-2743Stefan Feuerriegelhttps://orcid.org/0000-0001-7856-8729Felix Wortmannhttps://orcid.org/0000-0001-5034-2023Thomas Zügerhttps://orcid.org/0000-0001-6190-7405Christoph Stettlerhttps://orcid.org/0000-0003-1691-6059Elgar Fleischhttps://orcid.org/0000-0002-4842-1117A Baki Kocaballihttps://orcid.org/0000-0002-8328-5317Tobias Kowatschhttps://orcid.org/0000-0001-5939-4145 BackgroundHypoglycemia is a frequent and acute complication in type 1 diabetes mellitus (T1DM) and is associated with a higher risk of car mishaps. Currently, hypoglycemia can be detected and signaled through flash glucose monitoring or continuous glucose monitoring devices, which require manual and visual interaction, thereby removing the focus of attention from the driving task. Hypoglycemia causes a decrease in attention, thereby challenging the safety of using such devices behind the wheel. Here, we present an investigation of a hands-free technology—a voice warning that can potentially be delivered via an in-vehicle voice assistant. ObjectiveThis study aims to investigate the feasibility of an in-vehicle voice warning for hypoglycemia, evaluating both its effectiveness and user perception. MethodsWe designed a voice warning and evaluated it in 3 studies. In all studies, participants received a voice warning while driving. Study 0 (n=10) assessed the feasibility of using a voice warning with healthy participants driving in a simulator. Study 1 (n=18) assessed the voice warning in participants with T1DM. Study 2 (n=20) assessed the voice warning in participants with T1DM undergoing hypoglycemia while driving in a real car. We measured participants’ self-reported perception of the voice warning (with a user experience scale in study 0 and with acceptance, alliance, and trust scales in studies 1 and 2) and compliance behavior (whether they stopped the car and reaction time). In addition, we assessed technology affinity and collected the participants’ verbal feedback. ResultsTechnology affinity was similar across studies and approximately 70% of the maximal value. Perception measure of the voice warning was approximately 62% to 78% in the simulated driving and 34% to 56% in real-world driving. Perception correlated with technology affinity on specific constructs (eg, Affinity for Technology Interaction score and intention to use, optimism and performance expectancy, behavioral intention, Session Alliance Inventory score, innovativeness and hedonic motivation, and negative correlations between discomfort and behavioral intention and discomfort and competence trust; all P<.05). Compliance was 100% in all studies, whereas reaction time was higher in study 1 (mean 23, SD 5.2 seconds) than in study 0 (mean 12.6, SD 5.7 seconds) and study 2 (mean 14.6, SD 4.3 seconds). Finally, verbal feedback showed that the participants preferred the voice warning to be less verbose and interactive. ConclusionsThis is the first study to investigate the feasibility of an in-vehicle voice warning for hypoglycemia. Drivers find such an implementation useful and effective in a simulated environment, but improvements are needed in the real-world driving context. This study is a kickoff for the use of in-vehicle voice assistants for digital health interventions.https://humanfactors.jmir.org/2024/1/e42823 |
| spellingShingle | Caterina Bérubé Vera Franziska Lehmann Martin Maritsch Mathias Kraus Stefan Feuerriegel Felix Wortmann Thomas Züger Christoph Stettler Elgar Fleisch A Baki Kocaballi Tobias Kowatsch Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial JMIR Human Factors |
| title | Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial |
| title_full | Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial |
| title_fullStr | Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial |
| title_full_unstemmed | Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial |
| title_short | Effectiveness and User Perception of an In-Vehicle Voice Warning for Hypoglycemia: Development and Feasibility Trial |
| title_sort | effectiveness and user perception of an in vehicle voice warning for hypoglycemia development and feasibility trial |
| url | https://humanfactors.jmir.org/2024/1/e42823 |
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